PREVALENCE OF AND RISK FACTORS FOR IRON DEFICIENCY AMONG ANAEMIC PRE-SCHOOL CHILDREN ATTENDING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA

Abstract

Iron Deficiency is reported as the most important cause of anaemia the world
over. Recent global estimates indicate that more than one billion people are affected
by this condition. In children, iron deficiency has been linked to poor growth, reduced
immunity and retarded psychomotor development. Several factors have been
associated with increased risk of development of iron deficiency. Identification and
control of these factors will greatly reduce the burden of this problem. This
prospective study was carried out between the months of January and October 2008
primarily to determine the prevalence of and risk factors for iron deficiency among
anaemic children aged 6 to 59 months presenting at the Ahmadu Bello Univeristy
teaching Hospital (ABUTH), Zaria.
Three hundred and forty seven anaemic children were evaluated clinically and
had blood, stool and urine specimens analysed using standard laboratory methods.
Iron deficiency anaemia occurred in 223 children giving an overall prevalence of
64.3%. The prevalence of iron deficiency anaemia with respect to age in this study
was 22.0% in the later half of infancy, peaked at 51.6% in the second year of life and
then dwindled to 3.6% in subjects in their fifth year of life (χ2=27.7, p<0.001). There
was no sex specific difference between iron deficient and non-iron deficient children
(χ2 =2.05, p=0.179). One hundred and forty five (67.0%) of the iron deficient subjects
in the study had abnormal physical growth compared to 65(33.0%) non iron deficient
subjects. This difference was statistically significant (χ2=5.297, p=0.023.). Of this
proportion of iron deficient subjects, the prevalence of underweight was 38.6%;
35.4% were stunted and wasting 9.0%. Besides pallor which was the entry point, the
presence of blue sclera and koilonychia were the only significant clinical findings
among iron deficient subjects (χ2=5.70, p=0.003 Vs χ2=4.33, p=0.011 respectively).
Children with iron deficiency anaemia had significantly lower MCV, MCH and
MCHC compared with the non-iron deficient subjects (p <0.001, p <0.001 and p<0.05
respectively)
Socioeconomic status of parents/guardians (χ2= 4.29, p=0.045) and lack of
exclusive breastfeeding in the first 6 months of life (χ2=5.58, p= 0.047) were the
important risk factors identified. The use of multivitamin preparations and
antihelminthics were significantly associated with reduced risk of iron deficiency
anaemia (OR=8.92, p=0.004 Vs OR=4.95, p=0.001 respectively). There was no
significant association between haemoglobin electrophoretic pattern and iron
deficiency anaemia (χ2=3.25, p=0.086) or presence of stool parasites and iron
deficiency anaemia (χ2=6.86, p=0.144). There was also no demonstrable association
between malaria parasitaemia and iron deficiency anaemia (χ2=2.24, p=0.160) or HIV
antibody status and iron deficiency anaemia among preschool children in this study
(χ2=2.90, p=0.224).
The present study, when compared to previous works, suggests an increase in
the prevalence rate of iron deficiency anaemia among preschool children. It also
suggests that it is mainly nutritional in origin as iron deficiency anaemia was found to
be associated with malnutrition. The findings also suggest that frequent deworming
and increasing the bioavailability of iron may reduce the risk of iron deficiency
among this group of children.

PREVALENCE OF AND RISK FACTORS FOR IRON DEFICIENCY AMONG ANAEMIC PRE-SCHOOL CHILDREN ATTENDING AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA